Pijl J P, Kwee T C, Slart R H J A, Glaudemans A W J M
Medical Imaging Center, Departments of Nuclear Medicine and Molecular Imaging and Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
2Department of Biomedical Photonic Imaging, University of Twente, Enschede, The Netherlands.
Clin Transl Imaging. 2018;6(1):61-67. doi: 10.1007/s40336-017-0261-8. Epub 2018 Feb 12.
Cyst infections are a common complication in autosomal dominant polycystic kidney disease (ADPKD). Diagnosing these infections often remains challenging. Conventional imaging techniques such as ultrasonography, computed tomography (CT), and standard magnetic resonance imaging have several drawbacks and disadvantages. The purpose of this pictorial essay was to illustrate and discuss the potential value of F-fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET)/CT in diagnosing cyst infection in ADPKD.
Exemplary (ADPKD) patients who underwent FDG-PET/CT as part of their routine clinical work-up in our institution are presented to show the potential value and drawbacks of this imaging technique in diagnosing cyst infection. In addition, the current literature and guidelines on this topic were reviewed.
FDG-PET/CT appears to be a sensitive method for the detection of cyst infection, but it is not infallible. Furthermore, FDG uptake in cysts and cyst-like lesions is not specific and clinical and radiological correlations are essential to improve specificity and minimize the risk of falsely discarding other diseases, in particular malignancy.
FDG-PET/CT seems to be a useful imaging modality to diagnose cyst infections in ADPKD. However, its exact diagnostic value has not been established yet due to the lack of a reliable reference standard in previous studies on this topic.
囊肿感染是常染色体显性多囊肾病(ADPKD)的常见并发症。诊断这些感染往往仍具有挑战性。传统的成像技术,如超声、计算机断层扫描(CT)和标准磁共振成像,存在一些缺点和不足。本文的目的是阐述并讨论F-氟-2-脱氧-D-葡萄糖正电子发射断层扫描(FDG-PET)/CT在诊断ADPKD囊肿感染中的潜在价值。
展示在我们机构接受FDG-PET/CT作为常规临床检查一部分的典型ADPKD患者,以说明该成像技术在诊断囊肿感染中的潜在价值和缺点。此外,还回顾了关于该主题的当前文献和指南。
FDG-PET/CT似乎是检测囊肿感染的一种敏感方法,但并非万无一失。此外,囊肿和囊肿样病变中的FDG摄取并不具有特异性,临床和放射学的相关性对于提高特异性以及将误诊其他疾病(尤其是恶性肿瘤)的风险降至最低至关重要。
FDG-PET/CT似乎是诊断ADPKD囊肿感染的一种有用的成像方式。然而,由于此前关于该主题的研究缺乏可靠的参考标准,其确切的诊断价值尚未确定。